
Marketplace Tech
The algorithm behind health insurance denials
Nov 21, 2024
T. Christian Miller, a ProPublica reporter, discusses his investigation into EviCore's controversial algorithm that determines health insurance claim approvals. He reveals how adjustments to this algorithm prioritize cost savings over patient care, resulting in increased claim denials. The conversation highlights the devastating impact of algorithmic decisions on real patients, showcasing the dangerous implications of automated systems in healthcare. Miller raises alarm over the potential conflicts of interest in the system that can lead to life-threatening delays for individuals in need of care.
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Quick takeaways
- Health insurers are increasingly utilizing algorithms to determine claim approvals, often prioritizing cost reduction over patient care, leading to serious risks.
- The tragic case of Little John Cupp illustrates the deadly consequences of algorithm-driven claim denials, emphasizing the urgent need for ethical healthcare practices.
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